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CITY OF SAN MARCOS <br />DISCLOSURE AFFIDAVIT-BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />The undersigned member of the City of San Marcos G.fi::1 Gov-v-1 C? I (name of City Board, <br />Commission, etc.) states under oath as follows: <br />I have a substantial interest in a business entity that may be involved in a vote or decision of the governmental body <br />described above, and the vote or decision may have a special economic effect on the business entity that is <br />distinguishable from the effect on the public. The name of the business entity is !5;OaT-A We S-+ Te ca.s <br />S-1-a.f-G Uvt ??/ e rsr ?, <br />The nature and extent of my interest in the business entity is as follows: (check all that apply) <br />Ownership of 10 percent or more of the voting stock or shares of the business entity. <br />Ownership of 10 percent or more of the fair market value of the business entity. <br />Ownership of $15,000 or more of the fair market value of the business entity. <br />V Funds received by me from the business entity exceed 10 percent of my gross income for the previous year. <br />The interest described above belongs to a person related to me in the first degree by consanguinity (natural <br />kinship) or affinity (marriage). Relative's name and relation: <br />The vote or decision involving this interest is on the j c, ( Li , Zoo I (date) agenda of the governmental <br />body, and is described as follows: .-e•-w+ SL j-ry o 2 e <br />r'n-d-i! G sF;L vti. KTSi.J . <br />EXECUTED on ?? ?? Z o ?! 1 (date). <br />v <br />Signature <br />SWORN T0,,AN1 me or <br />JANIS K. 0 K <br />Notary Public, State of Texas <br />Notary .St ' My Commissionf:xQW <br />"'?>±AUG. 13, 2001 <br />FILED on ` (date). <br />CitVSecretary <br />COSM Form 9/99 <br />Printed Name (,Oc 64 " kc.- ( Ka 0 ' h